Severe fatty metamorphosis of liver (No number). Comment on L-10 through L-12: Livers are pale, enlarged with ""rolled"" edges--one specimen (L-12) has been stained with Oil Red O to demonstrate the fat present in the tissue.
Portal cirrhosis; fatty degeneration. COMMENT: Specimens 13-22 are all examples of cirrhosis associated with alcoholism (Laennec's, portal, nutritional, alcoholic)--note that the specimens have a micronodular pattern in general with a generally uniform appearance to the nodules; however, note that some of the livers have nodules of up to about 1 cm. (see note below) and that there may be some variability in nodule size within one specimen. Intervening parenchyma is composed of fibrous septae. Also note that the remaining nodular liver parenchyma is quite pale or yellow = fatty change associated with continued alcohol abuse. Picture corresponding microscopic picture in your mind's eye of fatty change and cirrhosis (remember the definition of cirrhosis). Specimen #22 indicates that microscopically there is necrosis of hepatocytes with an inflammatory response = this is not evident grossly in this specimen. In this series, the small firm livers are good examples of end stage nutritional or alcoholic cirrhosis. NOTE: Although Robbins says that micronodular cirrhosis has nodules of up to 1 cm. in diameter, Dr. Hennigar's measurement of 3mm. and below is more characteristic.
Alcoholic cirrhosis . COMMENT: Specimens 13-22 are all examples of cirrhosis associated with alcoholism (Laennec's, portal, nutritional, alcoholic)--note that the specimens have a micronodular pattern in general with a generally uniform appearance to the nodules; however, note that some of the livers have nodules of up to about 1 cm. (see note below) and that there may be some variability in nodule size within one specimen. Intervening parenchyma is composed of fibrous septae. Also note that the remaining nodular liver parenchyma is quite pale or yellow = fatty change associated with continued alcohol abuse. Picture corresponding microscopic picture in your mind's eye of fatty change and cirrhosis (remember the definition of cirrhosis). Specimen #22 indicates that microscopically there is necrosis of hepatocytes with an inflammatory response = this is not evident grossly in this specimen. In this series, the small firm livers are good examples of end stage nutritional or alcoholic cirrhosis. NOTE: Although Robbins says that micronodular cirrhosis has nodules of up to 1 cm. in diameter, Dr. Hennigar's measurement of 3mm. and below is more characteristic.
Submassive hepatic necrosis with early postnecrotic cirrhosis. Comment: Nodular lesions represent attempt at regeneration. COMMENT ON SPECIMENS (#25-29): These illustrate the range of changes seen in autopsy livers from patients dying from viral hepatitis (liver disease or complications therefrom): #25=a liver that is bile stained and shows dark areas of necrosis but is not as massively necrotic as #26 and #27 (these two livers probably less than 800-900 gms) and although these two do not now show the usual maroon appearance, there has been a marked loss of hepatocytes. #28 and #29 show pale nodular areas interspersed in liver parenchyma which histologically demonstrates, besides necrosis, scarring or cirrhosis (#28 less, #29 more scarring). The nodular areas actually represent attempts at regeneration of hepatocytes.
Post-necrotic cirrhosis with portal vein thrombosis. COMMENT: Specimens (#30-33) all illustrate, whatever the etiology may be, more coarsely nodular (macronodular) livers that usually seen with alcoholic or nutritional cirrhosis, with many of the nodules greater than 1 cm. Broad scars and irregular sized nodules are characteristic.
